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In July 2025, Delhi’s Safdarjung Hospital, one of the largest Centre-run public healthcare institutions in the capital, was flooded after a heavy downpour. Images of patients wading through ankle-deep muck flooded legacy and social media, painting a grim picture.
This is not the first time this has happened. While the images raised a hue and cry for some time on social media, this seems to be an annual phenomenon at the hospital, with portions including the Central Institute of Orthopaedics OPD, Gynaecology department and doctors' hostels becoming most affected.
A month ago, in Mumbai, a similar situation played out in the city-run KEM hospital when rain led to waterlogging, especially in the Pediatric Intensive Care Unit (PICU) where infants are treated for serious illnesses.
While waterlogged hospitals are not an uncommon sight in India, climate events of a more catastrophic scale see loss of entire infrastructure in some places.
When we think of climate casualties, we think of people washed away in a flood or killed during an earthquake. But the health impacts of the these events continue to take or diminish the quality of lives affected by them for years to come.
Now, with floods in Uttarakhand and Jammu and Kashmir due to climate change-driven downpours and cloudbursts, severe flooding in Himachal Pradesh and Odisha, landslides in Arunachal Pradesh, and recurring urban floods in cities like Delhi and Mumbai, the health system of the whole country seems overwhelmed with the number of casualties and injuries.
These incidents are not isolated mishaps or mere acts of God. They are warnings of how climate disasters are crippling health systems across major Indian cities and states. And the ones paying the highest price are often the most vulnerable — children, women, the elderly, and the poor from marginalised communities.
Health Sector's Climate Footprint Remains Ignored
With climate incidents intensifying, there is urgent need for health systems to become both sustainable and resilient. This is because climate change is not just an environmental crisis but also a health crisis.
The World Health Organisation (WHO) estimates that between 2030 and 2050, climate-related incidents will cause approximately 250,000 additional deaths annually. Not just from direct impact but through undernutrition, malaria, diarrhoea, and heat stress alone. The economic cost of these health impacts is estimated to be between USD 2-4 billion per year by 2030. These put a very real burden on the health systems of countries, especially in the global south.
What is less known is that the healthcare sector itself is contributing to climate change through its carbon-intensive models of care.
According to Health Care Without Harm, the health sector accounts for 4.4 percent of the global Green House Gas emissions, equivalent to annual GHG emissions from 514 coal-fired power plants.
If the health sector were to be a country, it would be the fifth-largest green house gas emitter in the world. The top 3 emitters are the US, China, and the European Union. India has the seventh-largest absolute health sector climate footprint.
The main contributors of these emissions are energy consumption, transport, and product manufacture, use, and disposal. The breakdown of emissions according to the scopes is as follows:
Scope 1: 17 percent (direct emissions from healthcare facilities and vehicles).
Scope 2: 12 percent (indirect emissions from electricity, steam, cooling, and heating).
Scope 3: 71 percent (healthcare supply chain through the production, transport, and disposal of goods and services).
These emissions are not just numbers. They translate into pollution, higher respiratory disease rates, and unsafe waste management that disproportionately affects sanitation workers.
'Building Resilience Requires Long Term Commitment'
The WHO defines a climate-resilient health system as “one that is capable to anticipate, respond to, coping with, recover from, and adapting to climate-related shocks and stress”.
This indicates adopting sustainable, carbon-free practices which can go a long way, in serving future generations. For a country like India, it is particularly urgent.
More than 40 percent of Indian districts have healthcare systems that face very high to high climate risks such as floods, extreme heat, and droughts.
For families in flood-prone Meghalaya, power cuts in health centres caused by floods can mean disruption to critical services.
For heat-stressed workers in Rajasthan or Gujarat, it may mean overcrowded health centres with little cooling capacity. Without resilient health systems, climate shocks could overwhelm the already stretched public health infrastructure, leaving millions vulnerable.
While it is difficult to immediately reverse the effects of climate change, it is certainly possible to make our health systems more efficient and ensure preparedness to respond to climate challenges.
Firstly, it is necessary to build the capacity of health workers, facilities, and systems.
This entails sensitisation of health workers to climate change and its impact on health and health systems. Multi-sectoral coordination down to local level will help in localising the response according to the needs of a particular area/city.
Secondly, primary health care should be made accessible to everyone.
People with access to primary health care tend to be healthier as a community and hence, can be resilient to changing climate. It is the responsibility of governments to implement Universal Health Coverage to ensure good indicators of public health.
Thirdly, the focus should be on decarbonising health systems.
Decarbonising involves using clean and renewable energy, transitioning to zero emissions transport, procuring efficiently, implementing tele-health services wherever possible, growing food sustainably, building and designing infrastructure that is eco-friendly, and sustainably managing healthcare waste.
Right from the location of the health facility to the materials used in it (depending on the climate of the area) contribute to climate-resilient health systems.
Lastly, dedicated financing will be required to make the health systems resilient to climate change.
If the world has learned anything from the COVID-19 experience, it is that investments in public health systems are absolutely essential to address health challenges effectively.
Looking at the impact climate change has had on public health and will continue to have, the national governments must work on creating a fund for addressing health challenges of climate change. It is the responsibility of high-income countries to commit to financing.
Healthcare Must be Central to Climate Talks
National discussions on climate often focus on sectors like energy, transport, and agriculture, while healthcare gets little to no attention.
Yet, the contribution of the healthcare sector to the climate footprint is far from negligible. It is ironic that the very systems meant to heal and protect are also a source of harm.
This contradiction calls for a rethinking of how we build and run our health systems.
As countries prepare for COP 30 this year, health and healthcare must be at the centre of climate talks.
Today, we are caught in a vicious cycle where climate change affects the health of populations, which increases the demand for healthcare, which in turn increases emissions. Breaking this cycle is not only possible – it is urgent.
Only by building sustainable, climate-resilient health systems can we protect both people and the planet, ensuring that healthcare truly fulfils its purpose – to heal rather than harm.
(Sunila Dixit is a Research Analyst at The Takshashila Institute, Bangalore. Her research focuses on health policy and development areas that affect public health at large. This is an opinion piece and the views expressed above are the author’s own. The Quint neither endorses nor is responsible for them.)